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Choosing the Right Electronic Medical Record: Key Features and Considerations for Dermatology Practices
Choosing the Right Electronic Medical Record: Key Features and Considerations for Dermatology Practices
Choosing an electronic medical record (EMR) is one of the most important clinical and financial decisions a dermatology practice will make. An effective system can help streamline workflows, support high-quality patient care, and protect revenue, while the wrong choice can slow clinicians down and add to the administrative burden.
Dermatology workflows involve unique documentation, imaging, and billing needs that are not always well served by generic EMR platforms. To help guide the selection of an EMR, the following framework outlines key features and practice considerations specific to dermatology practices.
While many general EMRs offer customization, dermatology practices benefit greatly from ready-built, specialty-specific documentation tools. Key elements to evaluate include the following:
- Preconfigured dermatology templates for common conditions and procedures (eg, acne, psoriasis, melanoma, biopsies, cosmetic treatments)
- Smart-phrase libraries tailored to dermatologic language and examinations
- Ability to create, modify, and share custom templates across providers
Why It Matters—Efficient charting reduces documentation time, improves consistency, and supports accurate coding.
Dermatology is a highly visual specialty, making clinical photography and image management essential. Important capabilities of an EMR include the following:
- Easy capture, annotation, and longitudinal tracking of clinical images
- Seamless embedding of photographs directly into the patient chart
- Side-by-side comparison of current and prior images
- Secure image storage and camera integration
- Body-mapping tools to mark and track lesion locations visually
Why It Matters—A high-quality image workflow supports diagnosis, treatment planning, patient education, and medicolegal documentation.
For insurance-based practices, robust billing and revenue cycle management (RCM) tools are critical. For direct-care models, some of these items may be prioritized lower. Key features to compare include the following:
- Support for International Classification of Diseases, 10th Revision, Clinical Modification; Current Procedural Terminology; and dermatology-specific code sets
- Automated coding suggestions tied to clinical documentation
- Reviewing claims for errors and inconsistencies prior to submitting to payers’ insurance eligibility verification
- Electronic Remittance Advice/Explanation of Benefits posting and denial management workflows
- Support for cosmetic and self-pay billing
- Ability to generate superbills (itemized receipts for medical services that include International Classification of Diseases Tenth Revision and Current Procedural Terminology codes; patients can submit these directly to their insurance company for reimbursement) for direct-pay practices
Why It Matters—Strong RCM functionality protects revenue, reduces denials, and minimizes staff workload.
The most effective EMRs tightly integrate clinical charting with daily practice operations. Features to evaluate include the following:
- Integrated scheduling with color-coded calendars
- Appointment-type templates and block scheduling
- Automated patient reminders via text or email
- Support for multiprovider and multilocation practices
- Integration with outside pathology or lab services
Why It Matters—Clear and templated scheduling and practice integration help practices run more smoothly by reducing administrative workload and errors and coordinating communication between providers and even ancillary services.
Patient communication and virtual care are increasingly important in dermatology. When evaluating EMRs, compare the following:
- Built-in telehealth functionality vs third-party integrations
- Automated appointment reminders
- Patient portal features (forms, messaging, results)
- Online booking capabilities
Why It Matters—Integrated telehealth and patient communication tools improve access to care, enhance patient engagement, and streamline scheduling, messaging, and virtual visits within dermatology workflows.
Reporting capabilities support clinical quality, compliance, and business decision-making. Key reporting areas include the following:
- Clinical reports (outcomes, lesion tracking, disease management)
- Financial reports (revenue per provider, payer mix, visit types)
- Customizable or exportable reporting tools
Why It Matters—Robust reporting and analytics help dermatology practices track clinical outcomes, monitor financial performance, and make data-driven decisions to improve both patient care and practice management.
The user experience after implementation of the EMR is just as important as the software itself. Evaluate the following after the EMR is implemented:
- Initial training and onboarding resources
- Availability of dermatology-specific support teams
- Ongoing education, help centers, or user communities
- Access to dedicated implementation or success managers
Why It Matters—Strong training and support resources help ensure a smoother EMR implementation, faster staff adoption, and ongoing optimization of the system for dermatology workflows.
Finally, look beyond the sticker price. The total cost of ownership includes far more than monthly fees. Compare the following:
- Upfront costs (implementation, data migration, training)
- Subscription pricing (per provider or per user)
- Billing or RCM fees (including percentages of collections if applicable) and payment processing fees
- Costs for add-on modules (telehealth, imaging, analytics)
- Contract length and termination terms
Why It Matters—Understanding the full cost of ownership helps dermatology practices choose an EMR that fits their budget long-term while avoiding unexpected fees and contractual limitations.
There is no single “best” EMR for every dermatology practice. The right choice depends on your practice model, payer mix, clinical focus, and growth plans. By evaluating EMRs through a dermatology-specific lens and asking the right questions, you can choose a system that supports both excellent patient care and long-term practice success.
Choosing an electronic medical record (EMR) is one of the most important clinical and financial decisions a dermatology practice will make. An effective system can help streamline workflows, support high-quality patient care, and protect revenue, while the wrong choice can slow clinicians down and add to the administrative burden.
Dermatology workflows involve unique documentation, imaging, and billing needs that are not always well served by generic EMR platforms. To help guide the selection of an EMR, the following framework outlines key features and practice considerations specific to dermatology practices.
While many general EMRs offer customization, dermatology practices benefit greatly from ready-built, specialty-specific documentation tools. Key elements to evaluate include the following:
- Preconfigured dermatology templates for common conditions and procedures (eg, acne, psoriasis, melanoma, biopsies, cosmetic treatments)
- Smart-phrase libraries tailored to dermatologic language and examinations
- Ability to create, modify, and share custom templates across providers
Why It Matters—Efficient charting reduces documentation time, improves consistency, and supports accurate coding.
Dermatology is a highly visual specialty, making clinical photography and image management essential. Important capabilities of an EMR include the following:
- Easy capture, annotation, and longitudinal tracking of clinical images
- Seamless embedding of photographs directly into the patient chart
- Side-by-side comparison of current and prior images
- Secure image storage and camera integration
- Body-mapping tools to mark and track lesion locations visually
Why It Matters—A high-quality image workflow supports diagnosis, treatment planning, patient education, and medicolegal documentation.
For insurance-based practices, robust billing and revenue cycle management (RCM) tools are critical. For direct-care models, some of these items may be prioritized lower. Key features to compare include the following:
- Support for International Classification of Diseases, 10th Revision, Clinical Modification; Current Procedural Terminology; and dermatology-specific code sets
- Automated coding suggestions tied to clinical documentation
- Reviewing claims for errors and inconsistencies prior to submitting to payers’ insurance eligibility verification
- Electronic Remittance Advice/Explanation of Benefits posting and denial management workflows
- Support for cosmetic and self-pay billing
- Ability to generate superbills (itemized receipts for medical services that include International Classification of Diseases Tenth Revision and Current Procedural Terminology codes; patients can submit these directly to their insurance company for reimbursement) for direct-pay practices
Why It Matters—Strong RCM functionality protects revenue, reduces denials, and minimizes staff workload.
The most effective EMRs tightly integrate clinical charting with daily practice operations. Features to evaluate include the following:
- Integrated scheduling with color-coded calendars
- Appointment-type templates and block scheduling
- Automated patient reminders via text or email
- Support for multiprovider and multilocation practices
- Integration with outside pathology or lab services
Why It Matters—Clear and templated scheduling and practice integration help practices run more smoothly by reducing administrative workload and errors and coordinating communication between providers and even ancillary services.
Patient communication and virtual care are increasingly important in dermatology. When evaluating EMRs, compare the following:
- Built-in telehealth functionality vs third-party integrations
- Automated appointment reminders
- Patient portal features (forms, messaging, results)
- Online booking capabilities
Why It Matters—Integrated telehealth and patient communication tools improve access to care, enhance patient engagement, and streamline scheduling, messaging, and virtual visits within dermatology workflows.
Reporting capabilities support clinical quality, compliance, and business decision-making. Key reporting areas include the following:
- Clinical reports (outcomes, lesion tracking, disease management)
- Financial reports (revenue per provider, payer mix, visit types)
- Customizable or exportable reporting tools
Why It Matters—Robust reporting and analytics help dermatology practices track clinical outcomes, monitor financial performance, and make data-driven decisions to improve both patient care and practice management.
The user experience after implementation of the EMR is just as important as the software itself. Evaluate the following after the EMR is implemented:
- Initial training and onboarding resources
- Availability of dermatology-specific support teams
- Ongoing education, help centers, or user communities
- Access to dedicated implementation or success managers
Why It Matters—Strong training and support resources help ensure a smoother EMR implementation, faster staff adoption, and ongoing optimization of the system for dermatology workflows.
Finally, look beyond the sticker price. The total cost of ownership includes far more than monthly fees. Compare the following:
- Upfront costs (implementation, data migration, training)
- Subscription pricing (per provider or per user)
- Billing or RCM fees (including percentages of collections if applicable) and payment processing fees
- Costs for add-on modules (telehealth, imaging, analytics)
- Contract length and termination terms
Why It Matters—Understanding the full cost of ownership helps dermatology practices choose an EMR that fits their budget long-term while avoiding unexpected fees and contractual limitations.
There is no single “best” EMR for every dermatology practice. The right choice depends on your practice model, payer mix, clinical focus, and growth plans. By evaluating EMRs through a dermatology-specific lens and asking the right questions, you can choose a system that supports both excellent patient care and long-term practice success.
Choosing an electronic medical record (EMR) is one of the most important clinical and financial decisions a dermatology practice will make. An effective system can help streamline workflows, support high-quality patient care, and protect revenue, while the wrong choice can slow clinicians down and add to the administrative burden.
Dermatology workflows involve unique documentation, imaging, and billing needs that are not always well served by generic EMR platforms. To help guide the selection of an EMR, the following framework outlines key features and practice considerations specific to dermatology practices.
While many general EMRs offer customization, dermatology practices benefit greatly from ready-built, specialty-specific documentation tools. Key elements to evaluate include the following:
- Preconfigured dermatology templates for common conditions and procedures (eg, acne, psoriasis, melanoma, biopsies, cosmetic treatments)
- Smart-phrase libraries tailored to dermatologic language and examinations
- Ability to create, modify, and share custom templates across providers
Why It Matters—Efficient charting reduces documentation time, improves consistency, and supports accurate coding.
Dermatology is a highly visual specialty, making clinical photography and image management essential. Important capabilities of an EMR include the following:
- Easy capture, annotation, and longitudinal tracking of clinical images
- Seamless embedding of photographs directly into the patient chart
- Side-by-side comparison of current and prior images
- Secure image storage and camera integration
- Body-mapping tools to mark and track lesion locations visually
Why It Matters—A high-quality image workflow supports diagnosis, treatment planning, patient education, and medicolegal documentation.
For insurance-based practices, robust billing and revenue cycle management (RCM) tools are critical. For direct-care models, some of these items may be prioritized lower. Key features to compare include the following:
- Support for International Classification of Diseases, 10th Revision, Clinical Modification; Current Procedural Terminology; and dermatology-specific code sets
- Automated coding suggestions tied to clinical documentation
- Reviewing claims for errors and inconsistencies prior to submitting to payers’ insurance eligibility verification
- Electronic Remittance Advice/Explanation of Benefits posting and denial management workflows
- Support for cosmetic and self-pay billing
- Ability to generate superbills (itemized receipts for medical services that include International Classification of Diseases Tenth Revision and Current Procedural Terminology codes; patients can submit these directly to their insurance company for reimbursement) for direct-pay practices
Why It Matters—Strong RCM functionality protects revenue, reduces denials, and minimizes staff workload.
The most effective EMRs tightly integrate clinical charting with daily practice operations. Features to evaluate include the following:
- Integrated scheduling with color-coded calendars
- Appointment-type templates and block scheduling
- Automated patient reminders via text or email
- Support for multiprovider and multilocation practices
- Integration with outside pathology or lab services
Why It Matters—Clear and templated scheduling and practice integration help practices run more smoothly by reducing administrative workload and errors and coordinating communication between providers and even ancillary services.
Patient communication and virtual care are increasingly important in dermatology. When evaluating EMRs, compare the following:
- Built-in telehealth functionality vs third-party integrations
- Automated appointment reminders
- Patient portal features (forms, messaging, results)
- Online booking capabilities
Why It Matters—Integrated telehealth and patient communication tools improve access to care, enhance patient engagement, and streamline scheduling, messaging, and virtual visits within dermatology workflows.
Reporting capabilities support clinical quality, compliance, and business decision-making. Key reporting areas include the following:
- Clinical reports (outcomes, lesion tracking, disease management)
- Financial reports (revenue per provider, payer mix, visit types)
- Customizable or exportable reporting tools
Why It Matters—Robust reporting and analytics help dermatology practices track clinical outcomes, monitor financial performance, and make data-driven decisions to improve both patient care and practice management.
The user experience after implementation of the EMR is just as important as the software itself. Evaluate the following after the EMR is implemented:
- Initial training and onboarding resources
- Availability of dermatology-specific support teams
- Ongoing education, help centers, or user communities
- Access to dedicated implementation or success managers
Why It Matters—Strong training and support resources help ensure a smoother EMR implementation, faster staff adoption, and ongoing optimization of the system for dermatology workflows.
Finally, look beyond the sticker price. The total cost of ownership includes far more than monthly fees. Compare the following:
- Upfront costs (implementation, data migration, training)
- Subscription pricing (per provider or per user)
- Billing or RCM fees (including percentages of collections if applicable) and payment processing fees
- Costs for add-on modules (telehealth, imaging, analytics)
- Contract length and termination terms
Why It Matters—Understanding the full cost of ownership helps dermatology practices choose an EMR that fits their budget long-term while avoiding unexpected fees and contractual limitations.
There is no single “best” EMR for every dermatology practice. The right choice depends on your practice model, payer mix, clinical focus, and growth plans. By evaluating EMRs through a dermatology-specific lens and asking the right questions, you can choose a system that supports both excellent patient care and long-term practice success.
Choosing the Right Electronic Medical Record: Key Features and Considerations for Dermatology Practices
Choosing the Right Electronic Medical Record: Key Features and Considerations for Dermatology Practices
PRACTICE POINTS
- Choosing an electronic medical record (EMR) built for dermatology workflow is a critical part of practice management.
- Features of an EMR that should be evaluated include support for clinical documentation, scheduling and billing, and customer support.
- The proper EMR can reduce administrative tasks and protect practice revenue, but there is no one-size-fits-all option.
Noncompete Agreements and Their Impact on the Medical Landscape
In April 2024, the Federal Trade Commission (FTC) issued a nationwide rule to ban most employee noncompete agreements, including many used in health care1; however, that rule never took effect. In August 2024, a federal district court ruled that the FTC had exceeded its statutory authority and blocked the ban,2 and subsequent litigation and agency actions followed. On September 5, 2025, the FTC formally moved to accede to vacatur—in other words, it will not enforce the rule and backed away from defending it on appeal.3 As of December 2025, there is no active federal ban on physician noncompetes. The obligations of the physician employee are dictated by state law and the precise language of the contract that is signed.
In this article, we discuss the historical origins of noncompetes, employer and physician perspectives, and the downstream consequences for patient continuity, access, and health care costs.
Background
The concept of noncompete agreements is not new—this legal principle dates back several centuries, but it was not until several hundred years later, between the 1950s and 1980s, that noncompete agreements became routine in physician contracts. This trend emerged, at least in part, from the growing commoditization of medicine, the expansion of hospital infrastructure, and the rise of physicians employed by entities rather than owning a private practice. Medical practices, hospitals, and increasingly large private groups began using noncompete agreements to prevent physicians from leaving and establishing competing practices nearby. Since then, noncompetes have remained a contentious issue within both the legal system and the broader physician-employer relationship.
Employer vs Employee Perspective
From the employer’s perspective, health care systems and medical groups argue that noncompete agreements are necessary to protect legitimate business interests, citing physician training, established patient relationships, and proprietary information gained from employment with that entity as supporting reasons. Additionally, employers maintain that recouping the cost of recruitment and onboarding investments as well as sustaining continuity of care within the organization should take precedence. On occasion, health care systems will invest time and financial resources in recruiting physicians, provide administrative and clinical support, and integrate new employees into established referral pathways and patient populations. In this view, noncompetes serve as a tool to ensure stability within the health care system, discouraging abrupt departures that could fracture patient care or lead to unfair competition using institutional resources. While these arguments hold merit in certain cases, many physicians do not receive employer-funded education or training beyond what is required in residency and fellowship. As a result, the financial justifications for noncompetes often are overstated; on the contrary, the cost of a “buy-out” or the financial barrier imposed by a noncompete clause can amount to a considerable portion of a physician’s annual salary—sometimes multiple times that amount—creating an imbalance that favors the employer and limits professional mobility.
When a physician is prohibited from practicing in a specific area after leaving an employer, a complex web of adverse consequences can arise, impacting both the physician and the patients they serve. Physician mobility and career choice become restricted, effectively constraining the physicians’ livelihood and ability to provide for themselves and their dependents; in single-earner physician families, this can have devastating financial consequences. These limitations contribute to growing burnout and dissatisfaction within the medical profession, which already is facing unprecedented levels of stress and physician workforce shortages.4
Effect on Patients
When a physician is forced to relocate to a new geographic region because of a noncompete clause, their patients can experience substantial disruptions in care. Access to medical services may be affected, leading to longer wait-times and fewer available appointments, especially in areas that already have a shortage of providers. Patients may lose longstanding relationships with doctors who know their medical histories, which can interrupt treatment plans and increase the risk of complications. Those with chronic illnesses, complex conditions, or time-sensitive treatments are particularly vulnerable to adverse outcomes. Many patients must travel farther—sometimes out of their insurance network—to find replacement care, increasing both financial and logistical burdens. These abrupt transitions also can raise health care costs due to emergency department use, inefficient handoffs, and higher incidence of morbidity/mortality.5 Noncompete restrictions often prevent physicians from informing patients where they are relocating, creating confusion and fragmentation of care. As a result, trust in the health care system may decline when patients perceive that business agreements are being prioritized above their wellbeing. The impact may be even more severe in rural or underserved communities where alternative providers are scarce.
Final Thoughts
In recent years, noncompete agreements in health care have come under intensified scrutiny for their potential to stifle physician mobility, reduce competition, and inflate health care costs by limiting where and how physicians can practice. The trajectory of noncompetes in physician employment reflects broader shifts in how medicine is structured and delivered in the United States. In the latter half of the 20th century, what began as a centuries-old legal concept became a standard feature of physician employment contracts. That evolution largely was driven by the corporatization of medicine and large hospital group/private equity employment of physicians. As these agreements proliferated, public policy questions emerged: What does restricting a physician’s mobility do to patient access? To competition in provider markets? To the cost and availability of care? To the current epidemic of physician burnout?
These questions moved from the legal sidelines to center stage in the 2020s, when the FTC sought to tackle noncompetes across the entire economy—physicians included—on the theory they suppressed labor mobility, entrepreneurship, and competition. In February 2020, the American Medical Association submitted comments to the FTC on the utility of noncompete agreements in employee contracts stating that they restrict competition, can disrupt continuity of care, and may limit access to care.6 Although the FTC’s regulatory attempt in April 2024 provoked strong policy signals, it was challenged and ultimately blocked. Rather than a clear federal prohibition, the outcome is a more incremental state-based shift in rules governing physician noncompetes. For physicians today, this means more awareness and more leverage, but also more complexity. Whether a noncompete will be enforceable depends heavily on the state, the wording of the contract, the structure of the employer, and the specialty. From a negotiation standpoint, physicians need more guidance and awareness on the exact ramifications of their employee contract. For newly minted physicians, many of whom enter the workforce with considerable training debt, the priority often is securing employment to work toward financial stability, building a family, or both; however, all physicians should press for shorter durations, tighter geographic limits, narrower scopes of service, clear buy-out options, and explicit patient-continuity protections. Better yet, physicians can exercise the right of refusal to any noncompete clause at all. Becoming involved with a local medical organization or foundation can provide immense support, both in reviewing contracts as well as learning how to become advocates for physicians in this environment. As more physicians stand together to protect both practice autonomy and the right to quality care, we all become closer to rediscovering the beauty and fulfillment in the purest form of medicine.
- Federal Trade Commission. FTC announces rule banning noncompetes. April 23, 2024. Accessed December 1, 2025. https://www.ftc.gov/news-events/news/press-releases/2024/04/ftc-announces-rule-banning-noncompetes
- US Chamber of Commerce. Ryan LLC v FTC. August 20, 2024. Accessed December 1, 2025. https://www.uschamber.com/cases/antitrust-and-competition-law/ryan-llc-v.-ftc
- Federal Trade Commission. Federal Trade Commission files to accede to vacatur of non-compete clause rule. September 5, 2025. Accessed December 1, 2025. https://www.ftc.gov/news-events/news/press-releases/2025/09/federal-trade-commission-files-accede-vacatur-non-compete-clause-rule
- Marshall JJ, Ashwath ML, Jefferies JL, et al. Restrictive covenants and noncompete clauses for physicians. JACC Adv. 2023;2:100547.
- Sabety A. The value of relationships in healthcare. J Publich Economics. 2023;225:104927.
- American Medical Association. AMA provides comment to FTC on non-compete agreements. National Advocacy Update. February 14, 2020. Accessed November 25, 2025. https://www.ama-assn.org/health-care-advocacy/advocacy-update/feb-14-2020-national-advocacy-update
In April 2024, the Federal Trade Commission (FTC) issued a nationwide rule to ban most employee noncompete agreements, including many used in health care1; however, that rule never took effect. In August 2024, a federal district court ruled that the FTC had exceeded its statutory authority and blocked the ban,2 and subsequent litigation and agency actions followed. On September 5, 2025, the FTC formally moved to accede to vacatur—in other words, it will not enforce the rule and backed away from defending it on appeal.3 As of December 2025, there is no active federal ban on physician noncompetes. The obligations of the physician employee are dictated by state law and the precise language of the contract that is signed.
In this article, we discuss the historical origins of noncompetes, employer and physician perspectives, and the downstream consequences for patient continuity, access, and health care costs.
Background
The concept of noncompete agreements is not new—this legal principle dates back several centuries, but it was not until several hundred years later, between the 1950s and 1980s, that noncompete agreements became routine in physician contracts. This trend emerged, at least in part, from the growing commoditization of medicine, the expansion of hospital infrastructure, and the rise of physicians employed by entities rather than owning a private practice. Medical practices, hospitals, and increasingly large private groups began using noncompete agreements to prevent physicians from leaving and establishing competing practices nearby. Since then, noncompetes have remained a contentious issue within both the legal system and the broader physician-employer relationship.
Employer vs Employee Perspective
From the employer’s perspective, health care systems and medical groups argue that noncompete agreements are necessary to protect legitimate business interests, citing physician training, established patient relationships, and proprietary information gained from employment with that entity as supporting reasons. Additionally, employers maintain that recouping the cost of recruitment and onboarding investments as well as sustaining continuity of care within the organization should take precedence. On occasion, health care systems will invest time and financial resources in recruiting physicians, provide administrative and clinical support, and integrate new employees into established referral pathways and patient populations. In this view, noncompetes serve as a tool to ensure stability within the health care system, discouraging abrupt departures that could fracture patient care or lead to unfair competition using institutional resources. While these arguments hold merit in certain cases, many physicians do not receive employer-funded education or training beyond what is required in residency and fellowship. As a result, the financial justifications for noncompetes often are overstated; on the contrary, the cost of a “buy-out” or the financial barrier imposed by a noncompete clause can amount to a considerable portion of a physician’s annual salary—sometimes multiple times that amount—creating an imbalance that favors the employer and limits professional mobility.
When a physician is prohibited from practicing in a specific area after leaving an employer, a complex web of adverse consequences can arise, impacting both the physician and the patients they serve. Physician mobility and career choice become restricted, effectively constraining the physicians’ livelihood and ability to provide for themselves and their dependents; in single-earner physician families, this can have devastating financial consequences. These limitations contribute to growing burnout and dissatisfaction within the medical profession, which already is facing unprecedented levels of stress and physician workforce shortages.4
Effect on Patients
When a physician is forced to relocate to a new geographic region because of a noncompete clause, their patients can experience substantial disruptions in care. Access to medical services may be affected, leading to longer wait-times and fewer available appointments, especially in areas that already have a shortage of providers. Patients may lose longstanding relationships with doctors who know their medical histories, which can interrupt treatment plans and increase the risk of complications. Those with chronic illnesses, complex conditions, or time-sensitive treatments are particularly vulnerable to adverse outcomes. Many patients must travel farther—sometimes out of their insurance network—to find replacement care, increasing both financial and logistical burdens. These abrupt transitions also can raise health care costs due to emergency department use, inefficient handoffs, and higher incidence of morbidity/mortality.5 Noncompete restrictions often prevent physicians from informing patients where they are relocating, creating confusion and fragmentation of care. As a result, trust in the health care system may decline when patients perceive that business agreements are being prioritized above their wellbeing. The impact may be even more severe in rural or underserved communities where alternative providers are scarce.
Final Thoughts
In recent years, noncompete agreements in health care have come under intensified scrutiny for their potential to stifle physician mobility, reduce competition, and inflate health care costs by limiting where and how physicians can practice. The trajectory of noncompetes in physician employment reflects broader shifts in how medicine is structured and delivered in the United States. In the latter half of the 20th century, what began as a centuries-old legal concept became a standard feature of physician employment contracts. That evolution largely was driven by the corporatization of medicine and large hospital group/private equity employment of physicians. As these agreements proliferated, public policy questions emerged: What does restricting a physician’s mobility do to patient access? To competition in provider markets? To the cost and availability of care? To the current epidemic of physician burnout?
These questions moved from the legal sidelines to center stage in the 2020s, when the FTC sought to tackle noncompetes across the entire economy—physicians included—on the theory they suppressed labor mobility, entrepreneurship, and competition. In February 2020, the American Medical Association submitted comments to the FTC on the utility of noncompete agreements in employee contracts stating that they restrict competition, can disrupt continuity of care, and may limit access to care.6 Although the FTC’s regulatory attempt in April 2024 provoked strong policy signals, it was challenged and ultimately blocked. Rather than a clear federal prohibition, the outcome is a more incremental state-based shift in rules governing physician noncompetes. For physicians today, this means more awareness and more leverage, but also more complexity. Whether a noncompete will be enforceable depends heavily on the state, the wording of the contract, the structure of the employer, and the specialty. From a negotiation standpoint, physicians need more guidance and awareness on the exact ramifications of their employee contract. For newly minted physicians, many of whom enter the workforce with considerable training debt, the priority often is securing employment to work toward financial stability, building a family, or both; however, all physicians should press for shorter durations, tighter geographic limits, narrower scopes of service, clear buy-out options, and explicit patient-continuity protections. Better yet, physicians can exercise the right of refusal to any noncompete clause at all. Becoming involved with a local medical organization or foundation can provide immense support, both in reviewing contracts as well as learning how to become advocates for physicians in this environment. As more physicians stand together to protect both practice autonomy and the right to quality care, we all become closer to rediscovering the beauty and fulfillment in the purest form of medicine.
In April 2024, the Federal Trade Commission (FTC) issued a nationwide rule to ban most employee noncompete agreements, including many used in health care1; however, that rule never took effect. In August 2024, a federal district court ruled that the FTC had exceeded its statutory authority and blocked the ban,2 and subsequent litigation and agency actions followed. On September 5, 2025, the FTC formally moved to accede to vacatur—in other words, it will not enforce the rule and backed away from defending it on appeal.3 As of December 2025, there is no active federal ban on physician noncompetes. The obligations of the physician employee are dictated by state law and the precise language of the contract that is signed.
In this article, we discuss the historical origins of noncompetes, employer and physician perspectives, and the downstream consequences for patient continuity, access, and health care costs.
Background
The concept of noncompete agreements is not new—this legal principle dates back several centuries, but it was not until several hundred years later, between the 1950s and 1980s, that noncompete agreements became routine in physician contracts. This trend emerged, at least in part, from the growing commoditization of medicine, the expansion of hospital infrastructure, and the rise of physicians employed by entities rather than owning a private practice. Medical practices, hospitals, and increasingly large private groups began using noncompete agreements to prevent physicians from leaving and establishing competing practices nearby. Since then, noncompetes have remained a contentious issue within both the legal system and the broader physician-employer relationship.
Employer vs Employee Perspective
From the employer’s perspective, health care systems and medical groups argue that noncompete agreements are necessary to protect legitimate business interests, citing physician training, established patient relationships, and proprietary information gained from employment with that entity as supporting reasons. Additionally, employers maintain that recouping the cost of recruitment and onboarding investments as well as sustaining continuity of care within the organization should take precedence. On occasion, health care systems will invest time and financial resources in recruiting physicians, provide administrative and clinical support, and integrate new employees into established referral pathways and patient populations. In this view, noncompetes serve as a tool to ensure stability within the health care system, discouraging abrupt departures that could fracture patient care or lead to unfair competition using institutional resources. While these arguments hold merit in certain cases, many physicians do not receive employer-funded education or training beyond what is required in residency and fellowship. As a result, the financial justifications for noncompetes often are overstated; on the contrary, the cost of a “buy-out” or the financial barrier imposed by a noncompete clause can amount to a considerable portion of a physician’s annual salary—sometimes multiple times that amount—creating an imbalance that favors the employer and limits professional mobility.
When a physician is prohibited from practicing in a specific area after leaving an employer, a complex web of adverse consequences can arise, impacting both the physician and the patients they serve. Physician mobility and career choice become restricted, effectively constraining the physicians’ livelihood and ability to provide for themselves and their dependents; in single-earner physician families, this can have devastating financial consequences. These limitations contribute to growing burnout and dissatisfaction within the medical profession, which already is facing unprecedented levels of stress and physician workforce shortages.4
Effect on Patients
When a physician is forced to relocate to a new geographic region because of a noncompete clause, their patients can experience substantial disruptions in care. Access to medical services may be affected, leading to longer wait-times and fewer available appointments, especially in areas that already have a shortage of providers. Patients may lose longstanding relationships with doctors who know their medical histories, which can interrupt treatment plans and increase the risk of complications. Those with chronic illnesses, complex conditions, or time-sensitive treatments are particularly vulnerable to adverse outcomes. Many patients must travel farther—sometimes out of their insurance network—to find replacement care, increasing both financial and logistical burdens. These abrupt transitions also can raise health care costs due to emergency department use, inefficient handoffs, and higher incidence of morbidity/mortality.5 Noncompete restrictions often prevent physicians from informing patients where they are relocating, creating confusion and fragmentation of care. As a result, trust in the health care system may decline when patients perceive that business agreements are being prioritized above their wellbeing. The impact may be even more severe in rural or underserved communities where alternative providers are scarce.
Final Thoughts
In recent years, noncompete agreements in health care have come under intensified scrutiny for their potential to stifle physician mobility, reduce competition, and inflate health care costs by limiting where and how physicians can practice. The trajectory of noncompetes in physician employment reflects broader shifts in how medicine is structured and delivered in the United States. In the latter half of the 20th century, what began as a centuries-old legal concept became a standard feature of physician employment contracts. That evolution largely was driven by the corporatization of medicine and large hospital group/private equity employment of physicians. As these agreements proliferated, public policy questions emerged: What does restricting a physician’s mobility do to patient access? To competition in provider markets? To the cost and availability of care? To the current epidemic of physician burnout?
These questions moved from the legal sidelines to center stage in the 2020s, when the FTC sought to tackle noncompetes across the entire economy—physicians included—on the theory they suppressed labor mobility, entrepreneurship, and competition. In February 2020, the American Medical Association submitted comments to the FTC on the utility of noncompete agreements in employee contracts stating that they restrict competition, can disrupt continuity of care, and may limit access to care.6 Although the FTC’s regulatory attempt in April 2024 provoked strong policy signals, it was challenged and ultimately blocked. Rather than a clear federal prohibition, the outcome is a more incremental state-based shift in rules governing physician noncompetes. For physicians today, this means more awareness and more leverage, but also more complexity. Whether a noncompete will be enforceable depends heavily on the state, the wording of the contract, the structure of the employer, and the specialty. From a negotiation standpoint, physicians need more guidance and awareness on the exact ramifications of their employee contract. For newly minted physicians, many of whom enter the workforce with considerable training debt, the priority often is securing employment to work toward financial stability, building a family, or both; however, all physicians should press for shorter durations, tighter geographic limits, narrower scopes of service, clear buy-out options, and explicit patient-continuity protections. Better yet, physicians can exercise the right of refusal to any noncompete clause at all. Becoming involved with a local medical organization or foundation can provide immense support, both in reviewing contracts as well as learning how to become advocates for physicians in this environment. As more physicians stand together to protect both practice autonomy and the right to quality care, we all become closer to rediscovering the beauty and fulfillment in the purest form of medicine.
- Federal Trade Commission. FTC announces rule banning noncompetes. April 23, 2024. Accessed December 1, 2025. https://www.ftc.gov/news-events/news/press-releases/2024/04/ftc-announces-rule-banning-noncompetes
- US Chamber of Commerce. Ryan LLC v FTC. August 20, 2024. Accessed December 1, 2025. https://www.uschamber.com/cases/antitrust-and-competition-law/ryan-llc-v.-ftc
- Federal Trade Commission. Federal Trade Commission files to accede to vacatur of non-compete clause rule. September 5, 2025. Accessed December 1, 2025. https://www.ftc.gov/news-events/news/press-releases/2025/09/federal-trade-commission-files-accede-vacatur-non-compete-clause-rule
- Marshall JJ, Ashwath ML, Jefferies JL, et al. Restrictive covenants and noncompete clauses for physicians. JACC Adv. 2023;2:100547.
- Sabety A. The value of relationships in healthcare. J Publich Economics. 2023;225:104927.
- American Medical Association. AMA provides comment to FTC on non-compete agreements. National Advocacy Update. February 14, 2020. Accessed November 25, 2025. https://www.ama-assn.org/health-care-advocacy/advocacy-update/feb-14-2020-national-advocacy-update
- Federal Trade Commission. FTC announces rule banning noncompetes. April 23, 2024. Accessed December 1, 2025. https://www.ftc.gov/news-events/news/press-releases/2024/04/ftc-announces-rule-banning-noncompetes
- US Chamber of Commerce. Ryan LLC v FTC. August 20, 2024. Accessed December 1, 2025. https://www.uschamber.com/cases/antitrust-and-competition-law/ryan-llc-v.-ftc
- Federal Trade Commission. Federal Trade Commission files to accede to vacatur of non-compete clause rule. September 5, 2025. Accessed December 1, 2025. https://www.ftc.gov/news-events/news/press-releases/2025/09/federal-trade-commission-files-accede-vacatur-non-compete-clause-rule
- Marshall JJ, Ashwath ML, Jefferies JL, et al. Restrictive covenants and noncompete clauses for physicians. JACC Adv. 2023;2:100547.
- Sabety A. The value of relationships in healthcare. J Publich Economics. 2023;225:104927.
- American Medical Association. AMA provides comment to FTC on non-compete agreements. National Advocacy Update. February 14, 2020. Accessed November 25, 2025. https://www.ama-assn.org/health-care-advocacy/advocacy-update/feb-14-2020-national-advocacy-update
PRACTICE POINTS
- There is no active federal ban on physician noncompete agreements as of late 2025.
- Physician noncompetes have expanded alongside the corporatization of medicine but raise serious concerns about physician mobility, burnout, workforce shortages, and patient access to care, particularly in underserved areas.
- Physicians should critically evaluate noncompetes prior to signing an agreement, advocating for narrower limits or refusal altogether to protect professional autonomy, continuity of care, and patient welfare.
